Essay on Justice and Change in the Global World: Treatment Access

This essay examines the critical issue of patient access to prohibitively expensive medical treatments, particularly in Australia. It highlights the financial strain on patients due to the high cost of new drugs, especially those used to treat deadly diseases like cancer. The essay discusses the challenges faced by patients and oncologists, including the dilemma of choosing between prescribed medications and affordability. It explores the drug approval and subsidy processes in Australia, emphasizing the delays and financial burden on patients awaiting PBS listing. The essay also references the global context, noting the impact of unaffordable medicine costs on access to healthcare, especially for diseases like Hepatitis C. It then presents potential solutions, such as government pricing programs and managed entry systems, to improve access and affordability. The essay concludes by emphasizing the need for collaborative efforts from the pharmaceutical industry and government intervention to address the soaring medical costs and ensure equitable access to vital medications, referencing key studies and data from the field.

Justice and Change in global World
Running head: Justice and Change in the global world

Justice and Change in the global world 1
“Patient access to prohibitively expensive treatments”
In Australia, the use of drugs which are not subsidized by the government result in substantial
costs for the patients. The price of the new drugs specially to cure the deadly diseases like cancer
has created a challenge for the patients and their oncologists. According to Karikios et al. (2017)
patients receiving treatments with costly drugs are confronted with financial strains. Due the
heavy costs of the medicines, the patients choose to take fewer medicines than prescribed. Even
in the publicly aided hospitals, the doctors prescribe costly unsubsidized medicines resulting into
the psychological strain and financial distress to the patients.
Many drugs have been discovered to cure the deadly diseases such as cancer, hepatitis and many
more. These are welcomed by the patients and their medical practitioners since they increase the
response rates; increase the survival opportunities of the patients along with enhancing the
chances to cure them. But along with the advantages comes the considerably increased
expenses of these medicines.
Around 60 drugs have been sanctioned by the USA Food and Drug Administration between 2005
to 2014. The main problem is that the unaffordable prices of the drugs have posed a challenge for
the providers, payers and the patients. In order to be legally supplied in Australia, the prescribed
medicines require the permission from the Therapeutic Goods Administration. If the medicine is
permitted, the companies manufacturing the medicine can submit the application to the
Pharmaceuticals Benefits Advisory Committee for the medicines to be listed on the
Pharmaceuticals Benefits Scheme (PBS). Afterwards, the medicines which are listed on the PBS
are provided to the patients at a sponsored price (Vitry, Mintzes and Lipworth, 2016).
In Australia, even if the medicines are available at fewer prices, the increased cost of the
medicines to cure cancer is creating difficulties for the patients. For example, sometimes it takes
months or years to get the medicine listed on the PBS after it is approved. So, as a result, the
patient has to pay the full amount of the medicine which can amount to thousands of dollars per
month. In some cases, the pharmaceutical companies provide the access to the medicines through
cost sharing schemes or compassionate access programs but they may still comprise of huge out
of pocket expenses for the patients (Denaro and Martin, 2016).

Justice and Change in the global world 2
It implies that decision regarding the treatment of the disease is dependent upon the cost of the
medicines. As a result many patients miss the high cost treatments or discontinue them if the
expenditure becomes unaffordable. Around 150 million people are suffering from Hepatitis C in
the world. One third of the world’s population is lacking the access to medicines because of
poverty. Around half of the population in Africa and Asia are being affected with this disease.
Sadly, the medicines cost around 100 times of their annual earnings so as a result they are not
able to afford them. Thus medicines should not be a luxury. They should be available at nominal
prices to the poorest of the poor (LeWine, 2015).
So what should be done? Is there any solution to the problem? Yes, definitely there is! In the US,
the government has introduced special pricing programs which eliminate the incentives from the
prices of the medicines thereby providing the lowest prices in the market. With the help of tax
rebates and marketing deals, the government is encouraging to drug manufactures to benefit
millions of people. It is important to make the medicines accessible to the common man along
with searching for effective means to treat the rare diseases. According to one survey 8% people
stated cost as the reason for not accessing the medical specialist and 19 % people stated cost as
the reason for not visiting the general practitioner in 2017 (McRae and Gool,2017).
To curb this problem, easy accessibility to drugs may decrease their prices. In 2010, the
Australian Government and the local pharmaceutical industry agreed to formulate a Managed
Entry System (MES) (Wonder, Backhouse and Sullivan, 2012).
Hence to conclude, it can be said that the soaring medical costs have become a serious problem
for the patients which can result in unnecessary complications in the medical condition of the
patients. Even if they could afford them, managing the various medicines is a challenging task
for them. So, this problem can be curbed by the joint efforts of the pharmaceutical industry as
well as the intervention of the government.

Justice and Change in the global world 3
References
Denaro, C. and Martin, J. (2016) The challenge of costly drugs. Australian Prescriber .39(3), pp.
72-74.
Karikios, D.J., Mileshkin, L., Martin, A., Ferraro, D. and Stockler, M,R.(2017) Discussing and
prescribing expensive unfunded anticancer drugs in Australia. ESMO Open .2017(2), pp. 1-7.
LeWine, H.(2015) Millions of adults skip medications due to high cost . Harvard Health
Publishing [online] Available from: https://www.health.harvard.edu/blog/millions-skip-
medications-due-to-their-high-cost-201501307673 [Accessed 28thApril, 2018].
McRae, I.S. and Gool, K.C.V.(2017) Variation in the fees of medical specialists: problems,
causes, solutions. The Medical Journal of Australia. 206 (4),pp. 162-163.
Vitry, A., Mintzes, B. and Lipworth, W.(2016) Access to new cancer medicines in Australia:
dispelling the myths and informing a public debate. Journal of Pharmaceutical Policy and
Practice. 9(13), pp. 1-6.
Wonder, M., Backhouse, M.E. and Sullivan, S.D.(2012) Australian Managed Entry Scheme: A
New Manageable Process for the Reimbursement of New Medicines? Value in Health .15 (2012)
, pp. 586 –590.